Self-termination of ventricular fibrillation during transport by emergency medical service Sang Hoon Oh, Kyu Nam Park, Young Hee Park, Ji Seon Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.027
The American Journal of Emergency Medicine , Vol. 34 , Issue 5 ,
Published online: October 22 2015
x Ventricular fibrillation (VF) is usually sustained, and it typically results in death unless electrical defibrillation is successfully performed within minutes. Although VF has been reported to spontaneously occur in vivo in some animal models and a few cases of self-terminating VF have been documented in clinical practice, no such case has been previously reported involving out-of-hospital emergency medical service (EMS) personnel. We report a case of self-terminating VF due to ST-segment elevation myocardial infarction that was documented by continuous electrocardiogram (ECG) strip monitoring.
Editorial: Ambulance Diversion: the Con Perspective Yuko Nakajima, Gary M. Vilke
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.005
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: March 10 2015
x As the ultimate safety net, emergency departments (EDs) are expected to care for any patient, at any time, under any circumstances. When EDs are overwhelmed in periods of surge, one solution is to redistribute patients. A commonly used method for redistributing patients is ambulance diversion. Ambulance diversion is not a new phenomenon and, over time, has become commonly used by EDs to address the growing problem of ED overcrowding and saturation [1]. As ED visits have increased through the years, ambulance diversion has evolved into standard practice in many health systems.
Interaction of the diabetes mellitus and cardiac diseases on survival outcomes in out-of-hospital cardiac arrest Dayea Beatrice Jang, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Ok Ahn, Seung Sik Hwang, Young Taek Kim, Sung Ok Hong, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.076
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: December 29 2015
x Diabetes mellitus (DM) and cardiac disease (CD) both likely effect out-of-hospital cardiac arrest (OHCA) survival, but the effect of their relationship on survival outcomes is unclear. This study aims to investigate whether the association of DM and OHCA outcomes differ in patients with and without CD.
Prehospital endotracheal intubation and survival after out-of-hospital cardiac arrest: results from the Korean nationwide registry Kyung Kang, Taeyun Kim, Young Sun Ro, Yu Jin Kim, Kyung Jun Song, Sang Do Shin
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.036
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 2 2015
x Optimal out-of-hospital cardiac arrest (OHCA) airway management strategies are still controversial. Recent studies reported survival was higher among patients who received bag-valve-mask (BVM) than those receiving endotracheal intubation (ETI) or supraglottic airway (SGA). The aim of this study was to compare neurologically favorable survival outcomes among adult nontraumatic OHCA patients by prehospital airway.
Implementation of mechanical chest compression in out-of-hospital cardiac arrest in an emergency medical service system Christer Axelsson, Maria Jimenez Herrera, Martin Fredriksson, Jonny Lindqvist, Johan Herlitz
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.002
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 10 2013
x The aim of this study is to describe the outcome changes after out-of-hospital cardiac arrest (OHCA) in Gothenburg, Sweden, after introduction of mechanical chest compression (MCC).
Dynamic ambulance reallocation for the reduction of ambulance response times using system status management Sean Shao Wei Lam, Ji Zhang, Zhong Cheng Zhang, Hong Choon Oh, Jerry Overton, Yih Yng Ng, Marcus Eng Hock Ong
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.044
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: November 8 2014
x Dynamically reassigning ambulance deployment locations throughout a day to balance ambulance availability and demands can be effective in reducing response times. The objectives of this study were to model dynamic ambulance allocation plans in Singapore based on the system status management (SSM) strategy and to evaluate the dynamic deployment plans using a discrete event simulation (DES) model.
Does ambulance use differ between geographic areas? A survey of ambulance use in sparsely and densely populated areas Lena Marie Beillon, Björn-Ove Suserud, Ingvar Karlberg, Johan Herlitz
DOI: http://dx.doi.org/10.1016/j.ajem.2008.01.012
The American Journal of Emergency Medicine , Vol. 27 , Issue 2 ,
Published in issue: February 2009
x The aim of this study was to analyze possible differences in the use of ambulance service between densely and sparsely populated areas.
Emergency medical technician treatment of hypoglycemia without transport Jared Strote, Reed Simons, Mickey Eisenberg
DOI: http://dx.doi.org/10.1016/j.ajem.2007.05.030
The American Journal of Emergency Medicine , Vol. 26 , Issue 3 ,
Published in issue: March 2008
x We examine the safety and efficacy of emergency medical technicians (EMTs) providing treatment to stable hypoglycemic patients without transport or paramedic involvement, which is currently beyond their scope of practice.
The first-door-to-balloon time delay in STEMI patients undergoing interhospital transfer Jeong Ho Park, Ki Ok Ahn, Sang Do Shin, Won Chul Cha, Hyun Wook Ryoo, Young Sun Ro, Taeyun Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.058
The American Journal of Emergency Medicine , Vol. 34 , Issue 5 ,
Published online: December 22 2015
x Interhospital transfer delays for ST-elevation myocardial infarction (STEMI) patients requiring primary percutaneous coronary intervention (PCI) may be shortened by improved regional care systems. We evaluated the transfer process and first door-to-balloon (D1toB) time in STEMI patients who underwent interhospital transfer for primary PCI.
Cellular technology improves transmission success of pre-hospital electrocardiograms Nicholas Larochelle, Michael O’Keefe, Daniel Wolfson, Kalev Freeman
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.032
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 27 2013
x In rural settings, long distances and transport times pose a challenge for achieving early reperfusion goals in patients with ST-elevation myocardial infarction (STEMI). This study investigated the association between the method of pre-hospital 12-lead ECG transmission (radio transmission vs. cellular phone transmission) and the success of transmission and legibility of 12-lead ECGs in a rural setting.
Influence of emergency medical services systems and prehospital defibrillation on survival of sudden cardiac death victims Richard C. Hunt, John B. McCabe, Glenn C. Hamilton, Jon R. Krohmer
DOI: http://dx.doi.org/10.1016/0735-6757(89)90089-2
The American Journal of Emergency Medicine , Vol. 7 , Issue 1 ,
Published in issue: January 1989
x This article reviews the influence of emergency medical systems and prehospital defibrillation on survival of sudden cardiac death. The historical perspective and epidemiologic considerations of prehospital sudden cardiac death are highlighted. Factors predictive of successful resuscitation and impact of community activity on sudden death are discussed. Influences of emergency medical services on outcome of prehospital cardiac arrest are reviewed, with emphasis on the role of dispatchers, emergency medical technicians, and paramedics.
Medication prescribing errors in the prehospital setting and in the ED Adi Einan Lifshitz, Lee Hilary Goldstein, Moshe Sharist, Refael Strugo, Einav Asulin, Shmuael Bar Haim, Zvi Feigenberg, Matitiahu Berkovitch, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.023
The American Journal of Emergency Medicine , Vol. 30 , Issue 5 ,
Published online: July 11 2011
x Medication errors are a common cause of iatrogenic adverse drug events. The incidence and nature of medication errors during prehospital treatment have not been fully described.
Timeliness of interfacility transfer for ED patients with ST-elevation myocardial infarction Michael J. Ward, Sunil Kripalani, Alan B. Storrow, Dandan Liu, Theodore Speroff, Michael Matheny, Eric J. Thomassee, Timothy J. Vogus, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.067
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: January 6 2015
x Most US hospitals lack primary percutaneous coronary intervention (PCI) capabilities to treat patients with ST-elevation myocardial infarction (STEMI) necessitating transfer to PCI-capable centers. Transferred patients rarely meet the 120-minute benchmark for timely reperfusion, and referring emergency departments (EDs) are a major source of preventable delays. We sought to use more granular data at transferring EDs to describe the variability in length of stay at referring EDs.
Fatal myocardial ischemia in a 12-year old secondary to fibromuscular dysplasia Paul M. Swaney, B. Daniel Nayman, Jose G. Cabañas, J. Brent Myers
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.027
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: December 19 2013
x Cardiac causes of chest pain in children are rare; however, they continue to account for 1% to 6% of all cases dependent on the practice setting and patient history. Here we describe the case of a 12-year old with fibromuscular dysplasia that died from an acute myocardial infarction. Although this specific etiology is uncommon, the case illustrates the need for broad differentials when treating children with chest pain in the emergency medicine environment. In particular, even if the specific diagnosis cannot be readily made in the prehospital or emergency department (ED) setting, the possibility of cardiac disease should be considered.
Ability of paramedics to treat patients with congestive heart failure via standing field treatment protocols Marc Eckstein, Deborah Suyehara
DOI: http://dx.doi.org/10.1053/ajem.2002.30106
The American Journal of Emergency Medicine , Vol. 20 , Issue 1 ,
Published in issue: January 2002
x The objective of the study was to determine if paramedics can accurately select the appropriate standing field treatment protocol (SFTP) in lieu of on-line medical direction (OLMD) for patients with congestive heart failure. A prospective case series over 18 months determined the sensitivity and positive predictive value (PPV) of paramedics' treatment of CHF patients using SFTPs. All patients who were treated under the “rales” protocol and transported to our base hospital were evaluated for appropriateness of field treatment with correlation to discharge diagnosis.
The prehospital 12-lead electrocardiogram's effect on time to initiation of reperfusion therapy: a systematic review and meta-analysis of existing literature Andrew Han Brainard, William Raynovich, Dan Tandberg, Edward J. Bedrick
DOI: http://dx.doi.org/10.1016/j.ajem.2005.02.004
The American Journal of Emergency Medicine , Vol. 23 , Issue 3 ,
Published in issue: May 2005
x The prehospital electrocardiogram (ECG) is becoming the standard of care of suspected cardiac chest pain. We evaluated the evidence regarding the prehospital ECG and sought to quantify the reduction in time to reperfusion therapy attributable to the prehospital ECG. We conducted a systematic review and analyzed studies that were conducted in emergency medical systems relevant to providers in the United States. The papers were limited to studies that reported original data that compared prehospital ECG to no prehospital ECG groups.
Cardiac arrest with initial arrest rhythm of pulseless electrical activity: do rhythm characteristics correlate with outcome? Margaret Hauck, Jonathan Studnek, Alan C. Heffner, David A. Pearson
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.050
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: March 25 2015
x Cardiac arrest is a leading cause of death in the United States, with pulseless electrical activity (PEA) as a common initial arrest rhythm. We sought to determine if rate of electrical activity and QRS width correlate with survival in patients who present with PEA out-of-hospital cardiac arrest.
Announcements
DOI: http://dx.doi.org/10.1016/0735-6757(93)90098-V
The American Journal of Emergency Medicine , Vol. 11 , Issue 5 ,
Published in issue: September 1993
Prehospital opiate emergencies in Vienna D Seidler, C Woisetschlaeger, A Schmeiser-Rieder, M.M Hirschl, A Kaff, A.N Laggner
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90069-8
The American Journal of Emergency Medicine , Vol. 14 , Issue 4 ,
Published in issue: July 1996
x To establish baseline data on prehospital emergencies caused by opiates during a 4-month period, a retrospective analysis of run records of the Emergency Medical System in Vienna, the capital of Austria, was conducted. During the study period, there were 308 opioid emergencies involving 240 persons, an average of 2.5 overdoses per day. Severely compromised patients were treated in 67.8% of the 308 emergencies, and 79.3% of emergencies were transported to hospital; 52.5% of the involved persons were younger than 22 years of age.
Estimation of glomerular filtration rate and assessment of risk of stroke in an emergency setting Alfredo De Giorgi, Fabio Fabbian, Marco Pala, Ruana Tiseo, Francesco Portaluppi, Roberto Manfredini
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.012
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: June 13 2011
x In 2010, in the United States, about 795 000 people had a stroke, and about 80% of them are new cases; in Italy, the cases of stroke are about 195 000, with an incidence of 2.15 to 2.54 new cases-1000 inhabitants per year [1]. Stroke is the third cause of death, after myocardial infarction and cancer, with an associated high incidence of disability and average cost of €40 000 to €50 000 per patient per year [2]. The social impact of this disease in general population suggests the need to adequately inform the patient about the risk of developing the disease, because this could favor appropriate changes in lifestyle habits, reduction of blood pressure (BP), smoking, and the incidence of diabetes mellitus and other cardiovascular diseases.
